Florida Senate - 2012                        COMMITTEE AMENDMENT
       Bill No. SB 668
       
       
       
       
       
       
                                Barcode 766998                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RS            .                                
                  02/23/2012           .                                
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       The Committee on Health Regulation (Gaetz) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (a) of subsection (3) and paragraph
    6  (c) of subsection (12) of section 440.13, Florida Statutes, are
    7  amended, and paragraph (k) is added to subsection (3) of that
    8  section, to read:
    9         440.13 Medical services and supplies; penalty for
   10  violations; limitations.—
   11         (3) PROVIDER ELIGIBILITY; AUTHORIZATION.—
   12         (a) As a condition for to eligibility for payment under
   13  this chapter, a health care provider who renders services must
   14  be a certified health care provider and must receive
   15  authorization from the carrier before providing treatment. This
   16  paragraph does not apply to emergency care. An employer or a
   17  carrier may not refuse to authorize a physician to treat an
   18  injured employee solely because the physician is a dispensing
   19  practitioner, as defined in s. 465.0276. The department shall
   20  adopt rules to implement the certification of health care
   21  providers.
   22         (k) If a physician who is a dispensing practitioner as
   23  defined in s. 465.0276 receives authorization from an employer
   24  or a carrier to treat a claimant pursuant to paragraph (a), the
   25  physician may dispense and fill prescriptions for medicines
   26  under this chapter. For the purposes of dispensing and filling
   27  prescriptions for medicines, the department, the employer or
   28  carrier, or an agent or representative of the department, the
   29  employer, or the carrier may not select the pharmacy,
   30  pharmacist, or dispensing practitioner, as defined in s.
   31  465.0276, that the claimant must use.
   32         (12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
   33  REIMBURSEMENT ALLOWANCES.—
   34         (c) As to reimbursement for a prescription medication,
   35  regardless of the location from which or the provider from whom
   36  the claimant receives the prescription medication, the
   37  reimbursement amount for a prescription shall be the average
   38  wholesale price plus $4.18 for the dispensing fee, unless except
   39  where the carrier has contracted for a lower amount. If the drug
   40  has been repackaged or relabeled, the reimbursement amount is
   41  calculated by multiplying the number of units dispensed times
   42  the per-unit average wholesale price set by the original
   43  manufacturer of the underlying drug, which may not be the
   44  manufacturer of the repackaged or relabeled drug, plus a $4.18
   45  dispensing fee, unless the carrier has contracted for a lower
   46  amount. The repackaged or relabeled drug price may not exceed
   47  the amount otherwise payable had the drug not been repackaged or
   48  relabeled. Fees for pharmaceuticals and pharmaceutical services
   49  shall be reimbursable at the applicable fee schedule amount. If
   50  Where the employer or carrier has contracted for such services
   51  and the employee elects to obtain them through a provider not a
   52  party to the contract, the carrier must shall reimburse at the
   53  schedule, negotiated, or contract price, whichever is lower.
   54  However, if the employee elects to fill a prescription for
   55  medicines with a dispensing practitioner as defined in s.
   56  465.0276 who is not a party to such contract, reimbursement
   57  shall be at the applicable fee schedule amount. No Such contract
   58  may not shall rely on a provider that is not reasonably
   59  accessible to the employee.
   60         Section 2. This act shall take effect July 1, 2012.
   61  
   62  ================= T I T L E  A M E N D M E N T ================
   63         And the title is amended as follows:
   64         Delete everything before the enacting clause
   65  and insert:
   66                        A bill to be entitled                      
   67         An act relating to workers’ compensation; amending s.
   68         440.13, F.S.; authorizing an authorized physician who
   69         is also a dispensing physician to dispense and fill
   70         prescriptions; prohibiting the Department of Financial
   71         Services, an employer, or a carrier from selecting the
   72         pharmacy, pharmacist, or dispensing practitioner a
   73         claimant must use in certain circumstances; revising
   74         requirements for determining the amount of a
   75         reimbursement for repackaged or relabeled prescription
   76         medication; providing limitations; providing an
   77         effective date.